Newer Treatments for Psoriasis

Psoriasis Responds Well to Switch From Etanercept to Adalimumab

NEW YORK (Reuters Health) Aug 12 – Results of a small prospective study suggest that adalimumab (Humira, Abbott) is an effective and safe treatment option for psoriasis patients who don’t respond to etanercept (Enbrel, Amgen/Pfizer).

The Dutch researchers also report that the benefits of the second tumor necrosis factor (TNF)-blocker were just as good in patients with primary or secondary failure or intolerance to etanercept.

“The highest therapeutic efficacy of etanercept is after 24 weeks, which has been substantiated in all clinical trials with this drug,” she added in an email. However, Dutch guidelines require an improvement of 50% in the Psoriasis Area and Severity Index (PASI 50) after 12 weeks of biologic treatment.

For patients who fail both drugs she recommends a switch to ustekinumab (Stelara, Centocor Ortho Biotech), a monoclonal antibody to human interleukin-12/23, “especially (in) patients who experience primary failure on both drugs (but this is not evidence-based). Perhaps a third TNF-inhibitor could also be effective.”

This study was partially funded by Wyeth Pharmaceuticals, now part of Pfizer. Four of seven authors also report having received fees from various pharmaceutical manufacturers, including Wyeth, Pfizer, Centocor and Abbott.